Gleaux Solutions - Gleaux Solutions Consult Sign-up Form

Gleaux Solutions Consult Sign-up Form

Please answer these questions so that we can address your situation properly to provide the best solution available to you. During your consultation, we will have a conversation about your current situation and your expectations. Based on your answers, we will determine if you qualify for our services and make sure we are a good fit to work with each other.

Today's Date *

Primary Email*

First Name*

Last Name*

Maiden Name

Promo / Discount Code

Date of Birth*

Last 4 of SSN

Cell Phone*

Preferred Method of Contact*

Phone

Text

No Preference

Address Line 1*

City*

State / Province*

ZIP / Postal Code*

What is your goal for repairing your credit?*

How soon do you need to accomplish your goal?*

Are you currently in bankruptcy? (if discharged or dismissed, please select no)*

Are you currently in a financial crisis that can prevent you from paying your bills ON TIME over the next 6-9 months?*

Did your credit circumstance happen due to hardship?*

If yes, what was the hardship?

Have you worked with a Credit Repair Company in the past 12 months?*

Have you attempted to repair your credit in the last 12 months?*

Are you looking to hire a professional to help you with your credit?*

Yes

SmartCredit Credit Monitoring

Please click the link below to sign up for credit monitoring:*
www.smartcredit.com/gleauxsolutions

Smart Credit Password*

How did you hear about us?*

If referred, please list the name of the person or company below

If you had 1 hour to go anywhere, where would it be?*

What questions do you have about our services? Check more than one if applicable.*

How Does it Work?

How much does it Cost?

How Long Does it Take?

I don’t have any questions

I am ready to enroll